Mandibular Nerve Block for Long-Term Pain Relief in a Case of Refractory Burning Mouth Syndrome

Intra-articular facet joint injections commonly refer to the injection of a contrast media and local anesthetic solution, with or without corticosteroids, directly into the facet joint space. The purpose of this procedure is pain relief as well as to establish an etiological diagnosis for surgical interventions such as joint denervation or radiofrequency ablation. Medial branch block, or facet nerve block, refers to injection of local anesthetic and possible corticosteroids along the medial branch nerve supplying the facet joints. Cervical intra-articular and facet nerve block injections are often part of a work-up for general or focal neck pain, headaches, or cervical muscle spasms. There is limited evidence for short- and long-term pain relief with cervical intra-articular facet joint injections. Cervical medial branch nerve blocks with local anesthetics demonstrate moderate evidence for short- and long-term pain relief with repeat interventions, and strong evidence exists for long-term pain relief following cervical radiofrequency neurotomy.

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The Long Term Effectiveness of Genicular Nerve Blocks for Chronic Knee Pain: A Retrospective Study

Pain Management Case Reports ◽

10.36076/pmcr.2018/2/75 ◽

2018 ◽

pp. 75-77

Author(s):

Laura Anne Lynem

Keyword(s):

Retrospective Study ◽

Radiofrequency Ablation ◽

Pain Relief ◽

Knee Pain ◽

Nerve Block ◽

Nerve Blocks ◽

Chronic Knee Pain ◽

Post Procedure

Chronic knee pain is a leading cause of chronic disability and its symptoms have a profound impact on the lives of those suffering from it. Current treatment modalities for chronic knee pain include pharmacologic and nonpharmacologic interventions. Genicular nerve blocks are a new therapeutic alternative that have been shown to relieve chronic knee pain and may provide significant relief in patients who are either poor surgical candidates or are unwilling to accept the risks associated with surgery. Genicular nerve blocks may provide long term pain relief for chronic knee pain and radiofrequency ablation (RFA) may not be necessary. This Institutional Review Board (IRB) approved retrospective study conducted at a single center university hospital involved 44 patients aged 43 to 87 who received genicular nerve blocks for chronic knee pain. The primary purpose of this study was to determine if genicular nerve blocks provide effective long term pain relief for patients with chronic knee pain. The numeric rating scale was used to measure the patient’s knee pain at baseline, 30, 90, and 120 days post procedure. Patients experienced a mean pain level of 7.43 out of 10 before the genicular nerve block and 4.02 afterward representing an average improvement of 42.6% in pain relief overall post procedure follow-up. A t-test revealed a statistically significant difference between the mean pain score before and after the blocks (t = 8.534, P < 0.01). Overall, the patients experienced significant pain relief of an average of 111.9 days resulting in an average of 42.6 percent pain relief post procedure follow-up. Out of the 44 patients, 15 (34.1%) underwent a RFA after receiving a genicular nerve block procedure to further manage their chronic knee pain symptoms. In conclusion, we have found statistically significant evidence that genicular nerve blocks provide effective long-term pain relief for patients with chronic knee pain. Therefore, for patients who are not surgical candidates, genicular nerve blocks represent a viable alternative treatment for knee pain. Key words: Genicular nerve blocks, chronic knee pain, genicular nerves, genicular nerve radiofrequency ablation

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A systematic review of treatment for patients with burning mouth syndrome

Cephalalgia ◽

10.1177/03331024211036152 ◽

2021 ◽

pp. 033310242110361

Author(s):

Huann Lan Tan ◽

Jared G Smith ◽

Jan Hoffmann ◽

Tara Renton

Keyword(s):

Pain Score ◽

Lipoic Acid ◽

Cognitive Behaviour Therapy ◽

Burning Mouth Syndrome ◽

Alpha Lipoic Acid ◽

Behaviour Therapy ◽

Cognitive Behaviour ◽

Burning Mouth

Background Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments. Aim This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects. Materials and methods Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020). Results Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment. Conclusion A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions. Registration International Prospective Register of Systematic Reviews (PROSPERO): Protocol ID - CRD42020160892.

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Suicidal Behavior in a Patient with Burning Mouth Syndrome

Case Reports in Psychiatry ◽

10.1155/2014/405106 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Konstantinos Kontoangelos ◽

Evmorfia Koukia ◽

Vasilis Papanikolaou ◽

Aris Chrysovergis ◽

Antonis Maillis ◽

...

Keyword(s):

Chronic Pain ◽

Oral Cavity ◽

Psychiatric Comorbidity ◽

Burning Mouth Syndrome ◽

Burning Sensation ◽

Multiple Forms ◽

Case Presentation ◽

Local Pain ◽

Burning Mouth

Introduction. Chronic pain of the oral cavity is a long-term condition and like all other types of chronic pain is associated with numerous comorbidities such as depression or anxiety.Case Presentation. This is a case of a 93-year-old patient suffering from chronic oral cavity pain who repeatedly stabbed his palate due to ongoing local pain, over the last few months, which he could not further tolerate. The patient was suffering from depression and also a diagnosis of “burning mouth syndrome” (BMS) was made.Discussion. Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue or other oral sites. BMS has high psychiatric comorbidity but can occur in the absence of psychiatric diagnosis. Patients with multiple forms of pain must be considered as potential candidates for underdiagnosed depression (major) and suicidal thoughts.

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Continuous Maxillary and Mandibular Nerve Block for Perioperative Pain Relief: The Excision of a Complicated Pleomorphic Adenoma

Anesthesia & Analgesia ◽

10.1213/01.ane.0000181332.74791.fc ◽

2005 ◽

Vol 101 (5) ◽

pp. 1531-1532 ◽

Cited By ~ 7

Author(s):

Ashok Kumar ◽

Ashim Banerjee

Keyword(s):

Pain Relief ◽

Pleomorphic Adenoma ◽

Nerve Block ◽

Mandibular Nerve ◽

Perioperative Pain

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Burning mouth syndrome (BMS) – clinical symptoms

ORL ro ◽

10.26416/orl.51.2.2021.5437 ◽

2021 ◽

Vol 3 (1) ◽

pp. 34-36 ◽

Cited By ~ 1

Author(s):

Elena Claudia Coculescu ◽

Bogdan-Ioan Coculescu

Keyword(s):

Medical Practice ◽

Clinical Symptoms ◽

Burning Mouth Syndrome ◽

Dental Disease ◽

Know How ◽

Secondary Form ◽

Burning Mouth ◽

Attending Physician

The scientific news and the importance for medical practice of approaching this oro-dental disease is supported not only by the patient’s persistent long-term suffering, but also by the concern to know how to identify the possible etiopathogenesis, especially in the secondary form, which once identified and sanctioned therapeutically is successful for both the attending physician and the patient.

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